The First Job

[Wilsocam]

Here is my question: 
How much does your first job determine the future of your career?

 

I am a student who has just completed interviews at a few highly reputable PA programs. While interviewing at these programs, many of the directors made the comment, "Don't just come here because our school has a big name. Where you graduated from only gets you your first job. The rest of your career depends on what you did at that first job and the most recent job after that."

 

To me, that statement makes a lot of sense. I have talked to a handful of recruiters, Docs, PA's and PA educators about this and they have agreed. They have also added how important it is to find a first job that you not only can learn a lot from, but have ample opportunities for career growth. Some even went as far as to say that working in a rural clinic right out of school is a bad move, even if that is your ultimate goal, because of having fewer minds to learn from and less experience in "the extremes" when it comes to medical cases. They suggested working internal med at a bigger hospital, gaining experience and confidence in diagnostics/procedures, and then moving on to a rural clinic if thats where I still wanted to be.

 

Honestly, I do not have a definitive specialty that I am set on, but, if I had to choose at this moment, family practice would be in the mix. With that being said, programs like NHSC or the Army/Navy/AF equivalents are EXTREMELY appealing when it comes to paying for my education (I will be going to a phenomenal school, but it is coming at a price!), but I would hate to place limitations on my future career opportunities by being placed in the middle of Alaska (Or on a ship, in an army base, etc, etc...) with a PCP that has little to offer when it comes to my growth as a clinician.

I have no intentions of being a less-than-extraordinary PA, and would be willing to work off every penny of my expensive education if that meant I would be more competent and experienced when it is all said and done.

Any thoughts or opinions would be greatly appreciated.

[ventana]

School does not get you your first job

 

 

School allows you to sit for the boards

Passing boards gets your  -C

You get your first job

 

 

It is 100% what you make of it after that - you can write narcs for your friends, loose your license and go to jail(local PA did just this), or you can settle into a nice practice and churn along enjoying a career, or you can try different fields and broaden your horizons, or you can do a residency, or teaching....... pretty much anything you want to do.

 

School is just getting you and admission ticket to boards

[Wilsocam]

I understand how the process works; I'm taking about increasing your odds at a first choice job. If there is a high paying job with great hours in a great health facility in a popular field, having that "-C" doesn't distinguish you from any of the 20 other PA-C's that are applying for the same spot.  Graduating from a more reputable school may give you a bit of an edge if you are a new grad, but my intention of the post was to distinguish how much your initial job matters when it comes to attempting to move on up or, as ventana said, "broaden your horizons."

[user1234556]

I'm not sure to what degree, if any, your first job has the potential to limit you in the future, but I don't believe the name of the school you attend has any bearing whatsoever on where you are/aren't able to obtain your first job. In the real world, nobody cares where you graduated from as long as the school was accredited and you passed your boards. The only situation in which I can see this actually mattering is if, during the course of your education, you're able to acquire a stand-out letter of recommendation from a faculty member etc. with some type of personal connection to the practice you're hoping to join, who can help you get your foot in the door. Otherwise, this sounds like something you'd only hear from a program director while interviewing at such an institution... convenient, considering that's where you heard this. Not trying to be a negative nancy, but the reality is that these people have a product to sell, and that product is an education which can be obtained at a much lower cost from many other places. Of course they're going to explain/justify that expense by playing to a notion that it confers some type of advantage, whether real or imagined, to the people who will be pulling out their checkbook to become a butt in a seat there. When it's all said and done, you'll still be having to pay off your loans with the same salary as anyone else.

[winterallsummer]

I agree, you may get a job through a rotation but as far as getting some great job vs crummy one has a lot more to do with you as a person, location, who is hiring, connections to hear about unposted jobs, etc.

[Febrifuge]

I'm not sure of the statistic, but when my first job out of school turned out to be kind of a nightmare, I was reassured to learn that some surprisingly high percentage of new PAs -- something like 40% -- change jobs between Year 1 and Year 3 after school. So it's common for the first job to be a stepping stone, a poor fit, or otherwise not the thing that sets the direction of one's whole career.

 

As to why this is, I figure there's a mix of explanations. New grads accept dumb offers sometimes, so they learn more about what they're worth and find better jobs after a year or two. Employers who aren't used to working with PAs hire new grads, then don't know how to work with them properly. Employers who are used to us tend to either have happy PAs and low turnover, or high turnover and a growing number of former employees spreading the word about a toxic workplace -- and new grads might not be in on that knowledge.

 

Some of it is more general, in terms of how a practice or group is run, but when they hire an MD that new partner gets a say in the leadership or direction and when they hire a PA, that employee does not. My situation was one I have subsequently seen repeated here a few times; the practice promised a residency-lite type of scenario, with lots of mentoring and teaching time, and then just got too busy to keep that promise, which made me more of a machine responsible for admitting patients, but one that lacked some important programming.

 

Anyway, don't sweat it too much. If you're not doing a residency (and unlike several of my friends, I'm not convinced many or even most PAs need or would benefit from doing one), then think of your first job as your own personal residency-like period of time. Plan on feeling dumb and overwhelmed. Put time and effort into studying on your own. Find a way to repeat making the same mistakes ("make new mistakes" was my mantra for my first 2-3 years after school), and you'll gradually grow into the clinician you will be for your actual career.

 

Finding a first job that's a good fit for that clinician would be great, but I'd expect it to be unlikely, so that if it happens it's a bonus. The thing is to stick with it while you're growing, so you can tell if what isn't working is them, or you, or the specialty, or just one group or hospital system. If it's you, you can change it. If it's something else, you can change it by changing jobs, once you're ready.

[TWR]

What is going to get you your first job is how well you sell yourself not what PA program you attended.  Once you have your "C", the playing field is level.  This would be true for any job you apply for.

[acozadd]

There are many things that can factor in to how you get your first job. Contrary to what is being said, the school that you graduate from will have some bearing. A "big name" school may intrigue some hiring managers and lead to an interview, the rest is up to you from there. Some "smaller name" programs will have a great reputation of churning out quality PAs in their region, and if that is a region that you would ultimately like to end up, that would be a good route to go. Attending a program in a region that you want to live will lead to rotations in that region and networking prior to graduation, which would be more influential than program name.

 

Ultimately, you'll have to find SOMETHING that sets you apart from the rest of the crowd when it comes to landing your first position. I had good grades throughout undergrad and PA school, as well as a good class ranking and that helped secure interviews as a new grad. It was commented on in every interview that I attended. You just need to prove that you have a good work ethic, a good personality, and are a good fit for the practice. You'll find what sets you apart.

 

I believe that >50% of PAs will change jobs within the first 2 years of practice, so the first job wont make or break you. Failing to recognize if you are in a bad situation and staying in that situation would make or break you. There are a wide variety of reasons why people change... Changing specialties, changing location, looking to advance autonomy or pay, etc. I knew a PA who after 1 year received an average pay increase at their first job, who switched to another position in the same specialty looking for a PA with at least 1 year experience and increased salary by 15-20K.

[Corpsman2PA]

Here is my question:

How much does your first job determine the future of your career?

 

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I think to some extent, that first job opens doors that are otherwise shut to outsiders. There are a lot if jobs that are word of mouth, and if you make a name for yourself you'll get noticed.

However, I wouldn't say that it completely determines the future of your career.

As others have said, it is a great stepping stone to where you want to go.

 

As an aside FWIW- your school plays a small factor in getting that first job. In my case, a 'top 10' school attached to a top med school, and it was my pre-PA experience that ultimately got me in the door over other highly qualified applicants. My school, however, did get my resume noticed I'm sure.

 

 

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